Iowa Pharmacies Cater to Amish Patients

When Mylo Wells, PharmD, opened the first of 2 Iowa pharmacies in 2018, he saw it as a chance to give back to the Amish community in which he grew up.

Both Wells Hometown Drug in Bloomfield and Wells Hometown Drug in Keosauqua, which opened in January 2022, are located in rural counties where there is a large Amish presence.

Wells grew up on a dairy farm in Milton, where he worked closely with the Amish community as a child and got to know the people as individuals and understand their way of life.

When Wells opened his first pharmacy, many of the Amish people he had known since childhood started to spread the word about the business, which paved the way for Wells Hometown Drug to cater to a large Amish population.

“They know that they can rely on me because I’ve known people from the Amish community my whole life,” Wells said in an interview. “I don’t treat them any differently than I treat [other patients], but I am aware of the differences we have culturally.”

For starters, Wells has made the pharmacies accessible to the Amish community, providing a place to tie up horses and buggies. In addition, the pharmacies provide free delivery, as many members of the Amish community live 15 to 20 miles outside the towns where the pharmacies are located so it is not always feasible for them to travel each time they need to pick up prescriptions. Many Amish patients call about prescriptions from community phones because they typically do not have their own phones.

“When there was a whooping cough outbreak, we delivered probably somewhere around 500 doses of azithromycin in the time span of about 6 weeks,” Wells said.

Amish families are often large, many with 6 to 12 children. During that pertussis outbreak in 2019, each family received several doses of azithromycin at once. The pharmacy’s delivery driver would go house to house with the medication.

We worked really closely with public health with that,” Wells said. “They would actually go out and assess the patients, and then they relied on us to get to the medication to them.”

Another challenge of working with the Amish community is that members often do not have health insurance, so prescriptions are paid for in cash.

Wells works with them to obtain affordable medications, often using in-house discounts or calling physicians to see if they can prescribe cheaper alternatives, such as a comparable drug or a generic substitute. During the pertussis outbreak, for instance, Wells worked with the elders of the Amish church to help provide price breaks for the antibiotics the community needed.

Because the pertussis outbreak preceded the COVID-19 pandemic, the Amish community, the Iowa Department of Public Health, and Wells Hometown Drug had a dress rehearsal of how to deal with and treat infectious diseases.

One outgrowth of the 2019 pertussis outbreak was the pharmacies’ shift to the Medsync software program, which is designed to help pharmacies streamline their workflows by synchronizing patient medication schedules.

“It lines all their medication up,” Wells said. “They come once a month, then if we need to check [their] blood pressure medication...we have time to do that.”

Using Medsync freed up the pharmacy staff members to provide clinical services and answer patient questions. That proved invaluable during the pandemic, especially once vaccines were rolled out, which consumed a lot of their time. Medsync allowed the pharmacy to better serve patients who were picking up prescriptions.

Clinical services for Amish patients often include counseling about the importance of taking needed prescription medications.

“The Amish believe in a lot of homeopathic medicine,” Wells said. “They are, in general, less trusting of prescription medications than the general public, so I just try to really reassure them on why they need the prescription medications they do receive.”

Because Amish people do not generally use the internet, they rely on pharmacy staff members to talk to them in person and provide printed materials about their medications.

After the pertussis outbreak, Wells said members of the Amish community started to get the Tdap vaccine to avoid another outbreak.

Although that was a good sign, he said finds the Amish are not as accepting of the COVID-19 vaccines, so he continues to educate them about the importance of getting vaccinated.